Thursday, August 16, 2012

Sex Selection

Are there ever times you feel a little – uncomfortable – with a woman’s reason for having an abortion? We’re not all Saints of Non-judgment, though some of us may strive to be. (Err…maybe some of us don’t…)

Last week, a recent immigrant from an Asian country (I won’t say which) came to our clinic for an abortion. I was the abortion counselor that day. She was in her second trimester and wanted to know if we could figure out the sex of the fetus. This isn’t a completely strange question, but I don’t get asked that often.

Because she was less than 18 weeks and because we don’t perform diagnostic ultrasounds, I explained we wouldn’t be able to identify the sex. I let her know that usually diagnostic ultrasounds to determine the sex are done between 18-22 weeks and that if she had a physician/midwife, she could schedule an ultrasound with them at that time (as it is standard practice).

She wasn’t willing to wait at least another month to have an abortion. You know the drill: she’d have to travel out of state; the cost would be much higher; she’d have to spend time away from home; someone would have to watch her small daughter while she left the area (and explain why she needed a babysitter); and her husband would have to get a lot of time off work.

We don’t ask patients why they want to have an abortion. Really, it’s none of our business. Still, lots of women offer their reasons when we ask if they’re sure of their decision, if they have support, etc.

The woman from last week calmly offered she didn’t want to have a girl.

Look, I’m about as pro-choice as they come. As long as it is a patient’s own decision to have an abortion, I’m cool with it regardless of the circumstances or gestation. I’ll admit though, it took me a slight second to register what the patient was telling me. My brain hitched.

I nodded at her and she explained herself, though she didn’t owe me any explanation at all.

In her country (like in many), girls do not have as many opportunities as boys and are considered a burden. She and her family plan to go back to their country soon and they wouldn’t be able to afford another girl (it costs a lot of money to have girls marry/dowries).

There’s been some national controversy about this (like, in May); even the pro-choicers didn’t want to really talk about sex selection abortion occurring. The reality is, though: it does. It’s not very common in our country, and I’ve never heard anyone – except someone who is from an Asian country – even mention it, at work. And I’ve been doing abortion work a long time.

The concept seems very foreign to us; but, is it really? Globally, there is underlying sexism that drives the devaluation of women. It happens here, too. Please, how many people have raised their hands saying women in this country don’t deserve to be paid equally to men? (Rolling eyes.)

It was a good reminder for me that we’re here to support women, in whatever it is they want, and trust that they know what they need for themselves, even if we may not understand it. We don’t need to understand. We just need to be there.

13 comments:

"Globally, there is underlying sexism that drives the devaluation of women."

That's true, but I don't think the solution is for male babies to outnumber female babies. On principle, I have to defend all abortions for any reason, but I *really* do not like that people are doing this. It's very cynical, in my view.

Hi Jessica, Thanks for your comment. I agree that the solution is not for males to outnumber females; in fact, it shouldn't. It's shown that when this occurs, such as in India, violence against women substantially increases.

I don't think many Western women do it - there aren't real drivers in our society that encourage the beliefs (we don't have dowries, for example). I think, though, the real issue is sexism. I think that's what has to be tackled, honestly: this idea that women are commodities in some societies.

Outing Myself - This subsection of the abortion issue has always hit close to home for me . . .

What about those of us who aren't being pressured by our culture or society and still decide for ourselves that we do not want a baby of particular sex?

In my case I do not want to bear any males, it's a choice I made many, many years ago for my own valid reasons, a choice that is re-evaluated periodically and does not waver. Having made this decision, I know that finding out the sex accurately early is difficult, Planned Parenthood doesn't do diagnostic ultrasounds and I would probably end up having to go to a CPC (they love to discover the sex as early as possible to personify the pregnancy and shame a women into keeping it).

I am lucky to have married into a family that seems to do nothing but breed girls (5 generations with almost 45 children and only 4 of them are boys), the odds are stacked in my favor that I will not conceive a male pregnancy.

I am not the typical women you think of when sex-selective abortions are mentioned, I am not casting aside a female pregnancy because my family, culture and society tells me to - I would be making an educated decision for myself to not bear a a male pregnancy.

Outing Myself - This subsection of the abortion issue has always hit close to home for me . . .

What about those of us who aren't being pressured by our culture or society and still decide for ourselves that we do not want a baby of particular sex?

In my case I do not want to bear any males, it's a choice I made many, many years ago for my own valid reasons, a choice that is re-evaluated periodically and does not waver. Having made this decision, I know that finding out the sex accurately early is difficult, Planned Parenthood doesn't do diagnostic ultrasounds and I would probably end up having to go to a CPC (they love to discover the sex as early as possible to personify the pregnancy and shame a women into keeping it).

I am lucky to have married into a family that seems to do nothing but breed girls (5 generations with almost 45 children and only 4 of them are boys), they odds are stacked in my favor that I will not conceive a male pregnancy.

I am not the typical women you think of when sex-selective abortions are mentioned, I am not casting aside a female pregnancy because my family, culture and society tells me to - I would be making an educated decision for myself to not bear a a male pregnancy.

~ ~ ~ ~ ~ ~ ~

This comment wasn't posted the first time I submitted it - do other pro-choicers feel uneasy about this? Should I have just kept my mouth shut?

There doesn't seem to be a way to contact the Abortioneers about this - If you choose not to post this comment again, please email me - divineoubliette@yahoo.com

Just an FYI, in some states abortions based on sex selection is illegal. This was the case in PA, where I used to work. Check the laws in your state because if someone calls requested an abortion for this reason, it may be an anti-choicer trying to trick you or get you on record doing something they can manipulate to use for their agenda!

Oubli, thank you for your thoughtful comment and for reminding us that not all women who may seek a sex-selection abortion is from a culture where they're pressured into having one. I'm a mom, and I can relate to the desire of wanting a girl; during my first pregnancy, I really wanted a girl and hoped she would be.

I think the bottom line is that women have a myriad of reasons for choosing abortion. The reasons are personal and varied. Sadly, because of stigma, many women feel they need to justify their reasons; but I feel strongly that there's no real reason for this. Your reason for when/if you continue a pregnancy, and under what circumstances, are completely up to you. :)

. . . during the last four years to ban sex-selective abortion at the federal level and in 13 states, two of which—Oklahoma and Arizona—have already enacted such laws. http://www.guttmacher.org/media/nr/2012/05/30/index.html

As an abortion provider, I've thought about this a lot. I staunchly defend any woman's right to end any pregnancy for any reason, but still have a little gnarly feeling about a couple things like sex-selective abortions or when someone is aborting for an anomaly that seems pretty mild, and probably not syndromic. One thing that I think might be going on that makes it seem uncomfortable (other than concerns about underlying misogyny, women's rights, etc) is that aborting a pregnancy for some fetal characteristic makes the abortion more about the fetus rather than the woman. By identifying the pregnancy as unwanted for a reason tied to the pregnancy itself, it gives the pregnancy an identity - on some level it is saying "it's not that I don't want to be pregnant, i just don't want to be pregnant with YOU". When its because of a terrible anomaly, we see the tragedy and empathize with the parents for ending a pregnancy they wanted and losing a potential child they would have loved. When it is for something we feel is in a gray area, in that same way we are forced to acknowledge the potential child in the situation but can't necessarily muster the sympathy for the woman the same way, if we think the reason for ending the pregnancy is not compelling. It leaves us, as providers, with this conflicted feeling, where we support the woman's right to make the decision but with an uncomfortable insight into why people can think of it as wrong.

I just remember that this is a variation on "I might not agree with what you say, but will fight to the death to defend your right to say it".

It makes complete sense to me that part of the reason, as you said, that perhaps some of us may feel uncomfortable with certain reasons a woman may choose abortion, is because it makes the decision more about the fetus, than about her.

I have never thought of it this way. I'm still mulling over what you've said. I'm sure many of us are.

At the end of the day, to do this work (or at least to do it with compassion and long-term dedication), we do need to approach it from the standpoint you mentioned: "I might not agree with what you say, but will fight to the death to defend your right to say it".

...because it all comes down to the woman. Even if her reason may make us focus a bit on that very reason, it doesn't really matter. At least not to us. It doesn't have any direct impact on our lives. It's about her. And what she decides, or believes is best for her. Whether we can even begin to relate or not.

I happened upon your blog yesterday and must say I found it very interesting indeed. You are clearly passionate about your work and the rights of the women involved. You are consistent in your approach to the ethics of choice and I commend you for not shying away from a topic as controversial as sex selective abortion.I understand, from this piece, that your argument goes as follows: regardless of our culturally induced reticence about a woman's reason for her abortion, our primary duty is to respect that choice and help her terminate her pregnancy.With that in mind would you equally support her choice on the grounds of race? So if, for example, a white woman had become pregnant by a black man but did not wish to have a mixed race child?I'm sorry for dealing in hypotheticals, but I was struck by your honesty and integrity when dealing with such a difficult topic and hoped you would extend that to satisfy my curiosity.All the best.

You raise an interesting question. Ultimately, I would would equally support any woman, for any reason, seeking an abortion. For me, the reason is not relevant. Do some reasons make me uncomfortable? Yes. Do some reasons more than others make me uncomfortable. Certainly.

The reason you raised actually is one that would make me most uncomfortable.

I actually had a situation where a university student told me, while I was counseling her, that the reason for her abortion was because she her parents would freak if she had a bi-racial child. She also then followed-up with many other reasons, too. Some of those included that she hadn't finished her education yet, she wasn't going to marry the man she was with, she didn't want to be a single mom, and she wanted to be sure she had a full-chance at her future (by not becoming a single parent).

I was very uncomfortable. Our philosophy was not to ever ask women the reason behind their abortions and this is a view I still strongly stand behind. Legally, you don't have to ask a woman that question. She offered it on her own.

After counseling many women, hers is a story that sticks out. And is one of the only where I did feel uncomfortable and found it difficult to understand. Hearing other reasons - though she didn't owe it to me at all - helped.

But at the end of the day, I do draw a firm line across what's mine and what's a patient's; what I mean is this: it is HER story. It is her life. Regardless of her reasons, I am there to support her. I may not get it. But I also know enough about life, and about this work, that nothing is that simple. It's often complicated. And I have to accept/trust that someone knows what's best for them.

All the best to you, too.

Thanks for your very thoughtful comment. We're happy you found our blog.

Thank you for taking the time to respond to my question. My interest in ethics extends beyond the main focus of your blog, and what often strikes me when discussing ethics is the inconsistency of people's approaches. This, however, could not be levelled at you. You are committed to your position and hold it with integrity, even if you might find some of the logical consequences somewhat unpalatable. I think this is to be commended.If you have the time and the inclination to indulge me further your response to my last question has piqued my curiosity some more. I understand your philosophical position to value autonomy as the ultimate consideration when considering ethical situations, I.e the woman's choice is paramount. Does that mean that you think she can never make a wrong choice as long as it is her choice?Thank you again for taking the time to indulge me. Please take my interest as a compliment on your genuinely fascinating blog.

This is not a debate forum -- there are hundreds of other sites for that. This is a safe space for abortion care providers and one that respects the full spectrum of reproductive choices; comments that are not in that spirit will either wind up in the spam filter or languish in the moderation queue.